# PRISMA HEALTH UNIVERSITY MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** University Medical Group/Internal Medicine Associates of Greenville
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083787006
- **Authorized official:** POLLY H MILLER (VP OF PAYOR STRATEGIES & ALIGNMENT)
- **Authorized official phone:** (864) 522-2286

## Contact information

- **Practice address:** 1025 VERDAE BLVD, SUITE A, GREENVILLE, SC 29607-4032
- **Practice address phone:** (864) 242-4683
- **Practice address fax:** (864) 240-8104
- **Mailing address:** 1025 VERDAE BLVD, SUITE A, GREENVILLE, SC 29607-4032
- **Mailing address phone:** (864) 242-4683
- **Mailing address fax:** (864) 240-8104

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | SC | Yes |
| 207RC0000X | Cardiovascular Disease Physician | — | SC | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | SC | — |
| 207RG0100X | Gastroenterology Physician | — | SC | — |
| 207RR0500X | Rheumatology Physician | — | SC | — |
| 208600000X | Surgery Physician | — | SC | — |

## Other

- **Enumeration date:** 11/16/2006
- **Last updated:** 08/20/2020